Articles Posted inPharma

Jazz Pharma, Alexion, and Lundbeck were the subject of SOJ lawsuits asserting kickbacks and committing general violations of Medicare laws. The United States Department of Justice has decided to agree to a settlement of $122.6 million in total from these three alleged Medicare violators.

The drug companies were accused of offering remuneration in hopes of encouraging patients to purchase their medications. They would pay kickbacks, a form of negotiated bribery, to patients of Medicare and Civilian Health and Medical Program (ChampVA) under the guise of charitable organizations that subsidized the co-pays. This is not an uncommon practice, but it is one many law enforcement programs are attempting to discontinue.

The DOJ states that in this case, the companies violated the Federal False Claims Act. This act is a way of imposing liability onto anyone, be it a group or individual, that has been discovered interfering with government-funded programs such as in this case with Medicare. This is one of the government’s main tools in defending against fraudulent acts.

With the increased frustration regarding inflated prescription drug prices, states like Florida are pushing for legislative programs that would permit the United States to import drugs from Canada. If this bill were to pass, it would allow many of the identical prescription drugs consumed by Americans to be purchased for a third of the price. However, this is not the first time a bill of this nature has been attempted.

In Utah, a similar bill that would have allowed the state to import prescription drugs from Canada was eventually turned down after lawmakers spent two-years developing the legislation. However, representatives in the state of Utah have not given up and claim that they will try a variation of the bill again next year. Leading the original legislation, as well as the upcoming bill is Republican Representative Norman Thurston.

However, the state of Florida is the next in the line to attempt to pass a similar version of this bill, which would permit the importation of prescription drugs for both Medicaid and prisoners. If passed, an additional program of the legislation would also allow the importation of these products for residents of the state.

Eli Lilly, a pharmaceutical giant known for their rapid-acting insulin, Humalog, has officially decided to release a generic version of insulin that will be nearly half the price of its name-brand product.

Not long before this announcement, many pharmaceutical leaders were gathered in order to discuss the issue concerning confusingly high drug prices. One of the main targets of this debate was the increase in pricing for insulin, in which people who have diabetes have been drastically rationing due to their inability to afford what they need to survive.

Holly Blakely, a former San Antonio pharmaceutical rep in Texas, plead guilty and confessed her involvement in an $8.8 million healthcare fraud scheme.

Initially, Holly Blakely was charged in a 30-count indictment. This allegedly means that she paid more than $400,000 in bribes and kickbacks to clinicians for prescribing compounded medications. Compound medication is basically personalized medications produced in order to fit an individual’s exact medical needs. In this case, these compound medications, in particular, were designed to ease pain, but the people these were being given to did not require them.

Blakely confessed that she worked with two compounding pharmacies in order to push prescriptions for compound drugs. The pharmacies would then submit claims to health plans such as Tricare. In exchange for her part of the fraud, Blakely was paid $1.15 million.

In 2009, the company Eli Lilly & Co. plead guilty to illegally marketing an antipsychotic drug, Zyprexa, for unapproved uses on patients, leading to a fine of $1.42 billion. This settlement ended a series of civil lawsuits, as well as a criminal investigation. At the time this large of a settlement was unheard of, but how did the company orchestrate such a massive kickback scheme?

The Kickback Scheme

Originally, Zyprexa was approved for a very narrow use of schizophrenia and bipolar disorder, however Eli Lilly & Co. soon began to market the drug for a variety of other purposes. In fact, it was alleged that Zyprexa was eventually marketed to treat dementia, and was even prescribed for illnesses related to pediatrics in high doses. The company was also accused of overcharging for the drug. This allowed the company to target a significantly wider audience, increasing their potential profits on the drug exponentially.

A former Insys Therapeutics executive, accused in an opioid bribe scheme, may have once gifted a lap dance to a doctor the company was pressuring to prescribe opioids drugs to patients. The troubling allegations are emerging as part of Insys trial in Boston.

Jurors heard the “lap dance” testimony on the second day of the federal trial in Boston against Insys Therapeutics founder, John Kapoor, and four other former executives. Apparently, Sunrise Lee, was a former exotic dancer with no experience in pharmaceuticals, who was hired to be a regional sales manager.

Holly Brown, a former Insys sales representative, testified that her superiors encouraged her and others of the sale team to focus their attention on a specific doctor who was known for prescribing a high amount of opioids, named Dr. Paul Madison. She says at one party she saw Lee sitting on Madison’s lap and “bouncing around,” with Madison’s hands “inappropriately all over” Lee’s chest. The prosecutors say this was part of an opioid bribe scheme.

The Sackler family empire comprises Purdue in America, Napp in Britain, and Mundipharma in Europe and Australasia. The companies have helped amass a £10 billion fortune, protected, in part, by the tax haven of Bermuda.

The Evening Standard in the UK released a report detailing that while their opioid painkillers are manufactured in Cambridge, the Caribbean is actually the heart of the Sacklers’ tax avoidance strategy. They report the Sackler family has allegedly diverted billions of pounds in profit to Bermuda to avoid paying millions in taxes that would have been due to the UK or Europe.

The pharmaceutical industry in Pasadena is much like the rest of the United States. There are certainly an influx of individuals who receive Medicare using these services for particular ailments and diseases that accompany being older than 65 years old. However, a local Pasadena pharmacy, Akhtamar Pharmacy, was abusing the Medicare funds provided for those particular individuals. Although the pharmacy owner did not act alone, she was able to steal $1.3 million dollars from the Medicare system.

Pasadena Pharmacy Owner Convicted for Medicare Fraud

Although the pharmaceutical industry is driven by a purpose to help those who need medication, it can also be a place for fraudulent acts to occur. With so much paperwork to be completed, many individuals find themselves taking advantage of the system by falsifying numbers or providing inaccurate invoices. Unfortunately, this was the case in a Pasadena pharmacy. A 39-year-old pharmacy owner, Tamar Tatarian, was convicted on one count of healthcare fraud and two counts of wire fraud at Akhtamar Pharmacy in Pasadena. It is believed that she committed the fraudulent acts which amounted to $1.3 million dollars in total.

One of the world’s largest drug manufacturing locations is becoming the center of a raging debate about the cost of good jobs versus safe drinking water. Hyderabad, India has become an economic center thanks to drug companies setting up shop. But alarming new reports say the monetary boost for the locals and big pharma has a hefty environmental price tag: pharmaceutical waste.

Pharmaceutical Waste Study

According to Technology Networks, drug companies in Hyderabad are dumping “untreated or inappropriately treated pharmaceutical waste into the environment.” There are several laws and regulations in place that detail how these drug manufacturers are supposed to treat waste, but a 2016 study highlighted that the companies were not following the guidelines.

New Tactics By The Justice Department Mean More Doctors May be Prosecuted

A new group of federal law enforcement nabbed their first indictment of a doctor in the fight against the opioid crisis. Valley News reports, the nationwide effort of law enforcement officials gives them all new access to prescription drug databases, Medicaid and Medicare figures, coroners’ records, and other numbers compiled by the Justice Department.

The Opioid Fraud and Abuse Detection Unit is a combination of law enforcement officials in 12 regions across the country. All united by the goal of stopping fraudulent doctors faster than before. The new organization of data means they have access to which doctors are prescribing the most, how far patients will travel to see them, and whether any of those patients have died within 60 days of receiving one of their prescriptions.